Quick answer: strep throat is a bacterial throat infection that usually starts suddenly with a painful sore throat and fever but no cough or runny nose. The flu is a viral illness that hits the whole body, with fever, cough, body aches, and exhaustion, and the sore throat is usually milder. Strep is treated with antibiotics; the flu is treated with rest, fluids, and sometimes antiviral medicine, which works best when started within 48 hours. A rapid strep test and a rapid flu test can tell them apart during one visit.
Strep throat vs. flu at a glance
- Cause: strep throat is caused by group A Streptococcus bacteria. The flu is caused by influenza viruses.
- Main symptoms: strep brings a sudden sore throat, pain with swallowing, fever, and swollen glands. The flu brings fever or chills, cough, body aches, headache, and fatigue, and sometimes a sore or runny nose.
- Cough and runny nose: common with the flu, unusual with strep.
- Who gets it most: strep is most common in children 5 to 15 years old. The flu affects all ages and is most dangerous for adults 65 and older, young children, pregnant people, and people with chronic conditions.
- Testing: a rapid strep swab and a rapid flu swab, both done during your visit.
- Treatment: antibiotics for strep. Rest, fluids, and antiviral medicine for the flu when appropriate.
Strep throat symptoms
- Sore throat that starts quickly, with pain when swallowing
- Fever
- Red, swollen tonsils, sometimes with white patches or streaks of pus
- Tiny red spots on the roof of the mouth
- Swollen, tender glands at the front of the neck
- Headache, stomach pain, nausea, or vomiting, especially in children
Flu symptoms
- Fever or feeling feverish, with chills
- Cough and sore throat
- Runny or stuffy nose
- Muscle or body aches and headache
- Fatigue that can be extreme
- Vomiting and diarrhea, more often in children
Flu symptoms usually come on suddenly. See our day by day flu symptom timeline.
Can you have strep and the flu at the same time?
Yes. The flu does not cause strep throat, but both infections can happen together, and a bacterial infection can follow the flu. If you have flu symptoms with a very sore throat and swollen glands, or you start to feel worse after improving, ask to be tested for both.
Treatment
Strep throat is treated with antibiotics, usually penicillin or amoxicillin. Antibiotics shorten the illness, reduce spread, and help prevent complications such as rheumatic fever. Take the full course even when you feel better. People with strep should stay home from work or school until they have no fever and have taken antibiotics for at least 24 hours.
The flu does not respond to antibiotics. Rest, fluids, and acetaminophen or ibuprofen help with symptoms. Prescription antiviral medicine can shorten the illness and lower the risk of complications, and it works best when started within 48 hours of the first symptoms; it is especially important for people at higher risk. Under current CDC guidance, you can return to normal activities when your symptoms have been improving overall and you have had no fever, without fever reducing medicine, for at least 24 hours.
Complications to know about
Untreated strep throat can lead to an abscess near the tonsils, rheumatic fever, which can damage the heart, and a kidney problem called post-streptococcal glomerulonephritis. Flu complications include pneumonia, sinus and ear infections, worsening of asthma, heart disease, or diabetes, and, in some people, heart attack or stroke.
Prevention
A yearly flu vaccine is the best protection against the flu. There is no vaccine for strep throat. For both, wash your hands often, cover coughs and sneezes, and do not share cups or utensils.
When to come to urgent care
- A sore throat with fever and no cough
- A sore throat that lasts more than 2 days
- Flu symptoms if you are 65 or older, pregnant, have a chronic condition, or are caring for a young child with symptoms
- Flu symptoms that improve and then return with fever or a worse cough
Go to the emergency room or call 911 for trouble breathing, chest pain or pressure, confusion, inability to swallow saliva or drooling, a muffled voice with severe one-sided throat pain, or signs of dehydration.
Related guides: mono vs. strep throat, strep throat vs. tonsillitis, and how long the flu is contagious. Sore throats and flu are evaluated at our cold and flu service.
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Advanced Urgent Care of Pasadena is at 797 S Arroyo Pkwy, Pasadena, next to Petco, with free on-site parking. We are open Monday through Friday 8 AM to 8 PM and Saturday and Sunday 9 AM to 5 PM, and we take our last patient 30 minutes before closing. You can walk in or reserve a time online. We serve Pasadena, South Pasadena, Altadena, San Marino, Alhambra, and nearby communities. Questions? Call (626) 304-0404. See our accepted insurance plans.
Sources
- CDC: About Strep Throat
- CDC: Signs and Symptoms of Flu
- CDC: Treatment of Flu
- CDC: Preventing Spread of Respiratory Viruses When You Are Sick
This article is general health information and is not a substitute for an examination by a medical provider. If you think you are having a medical emergency, call 911.